Asians constitute over 60% of the world's population. Over the past few decades, the burden of chronic diseases, particularly cardiovascular disease (CVD) and cancer, has increased substantially in Asian countries as a consequence of adverse lifestyle changes, including reduced physical activity, increased prevalence of obesity, cigarette smoking, and heavy alcohol consumption. Although each of the above modifiable factors has been linked to premature death, the overall impact of these factors on total and cause-specific mortality is unclear, particularly in the Asian populations. In 2008, we proposed, and have now successfully completed, the first analysis project in the Asia Cohort Consortium (ACC): to quantify the association between body mass index (BMI) and both total and cause-specific mortality by pooling and harmonizing data from over one million subjects across 18 cohort studies being conducted in Asian countries. In this application, we propose to expand the BMI pooling project to address study questions related to central obesity and other modifiable causes of death in Asians. We propose the following specific aims: 1) To evaluate the association between central obesity, as measured by waist-to-hip ratio (WHR), and both total and cause-specific mortality;and 2) To quantify the impact of major modifiable lifestyle factors, including high BMI, high WHR, cigarette smoking, and excessive alcohol drinking on both total and cause-specific mortality. Our consortium addresses the NCI objective to "expand the capacity of centers, networks, and consortia," and the goal to "create and sustain infrastructures that facilitate research collaboration" as outlined in the NCI Plans and Priorities. We anticipate that the analysis within the ACC will be a major step toward improving understanding of the causes and mechanisms of cancers and will enhance the collaboration within the consortium for further pooled analyses. The proposed study will generate substantial data that are valuable to inform policies and programs aimed at tackling the emerging epidemic of chronic diseases and to reduce premature death in Asian countries. PUBLIC HEALTH RELEVANCE: Project Narrative Although obesity (including central obesity), cigarette smoking, and excessive alcohol consumption are each known to increase mortality, the overall impact of these modifiable factors on mortality is unclear, particularly in the Asian population. The proposed study, with its large sample size and strong methodology, will allow us to investigate, systematically, these important questions. The results from this study will have important public health implications in disease prevention.